| NPI | 1831470939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRA WHITE President 718-933-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 176524) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 176524) |
| 207R00000X Internal Medicine (Licence: NY 176524) | |
| 207L00000X Anesthesiology (Licence: NY 176524) | |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2011-09-12 |